Gaza hospital caught in economic, political crossfire
Reageer (0)By Liam Stack, McClatchy Newspapers
26-9-2010
GAZA CITY, Gaza -- In the sweltering, dim emergency room of Gaza City's al-Shifa Hospital, Dr. Ehab al-Ramlawy fanned beads of sweat off his face with the shiny black X-ray slide.
Leaning over one patient's paperwork, he listened to a list of symptoms from the next. Behind him milled a restless crowd of the sick and infirm, bathed in the light from a nearby window, anxiously waiting for a piece of his time.
Al-Shifa is the biggest hospital in the Gaza Strip, but a years-long Israeli and Egyptian economic blockade as well as Palestinian political infighting have left it strapped for resources.
Its emergency room treats 400 people a day in one large, rundown room with 11 beds and a chronic shortage of medicine. Rolling blackouts leave it dependent on diesel-guzzling generators that run for more than 12 hours a day, and most departments have few lights and no air conditioning in the heat of summer. Advanced equipment lies unused and useless, crippled by a lack of spare parts.
"We lack equipment, and we lack many types of medicine," said Ayman al-Sohbani, the director of the ER.
"We manage to work, even if we do not have the things we regularly need," he said. "Sometimes we have something, and sometimes we don't; sometimes we fix things, and sometimes we can't."
Officials in Gaza's Ministry of Health say al-Shifa's problems reflect those at hospitals and clinics across the small territory of 1.5 million inhabitants. It has been cut off from the outside world by a blockade Israel and Egypt imposed after the militant group Hamas took power in Gaza in 2007 from the rival, Western-backed Palestinian Authority, which controls the West Bank.
Gaza health officials charge that the Palestinian Authority hoards medicine and supplies and is unresponsive to their needs. The Palestinian Authority denies the charge, and the World Health Organization greets it with skepticism. The WHO says Gaza's government is too poor to buy supplies and blames any supply holdups on the two Palestinian factions' distrust of each other and their inability to cooperate.
Under the terms of the blockade, machine parts that could serve a military purpose and construction materials such as steel and cement aren't allowed into Gaza.
These restrictions often bar spare parts, and they have left the Ministry of Health unable to repair damaged facilities, complete an expansion of Shifa that has been unfinished since 2006 or repair broken or malfunctioning equipment, ministry spokesman Ahmed al-Ashi said.
They also have prevented Gaza authorities from repairing all the damage to the Strip's electrical grid caused by Israeli airstrikes since 2006, so daily rolling blackouts are a fixture of life.
Complicating matters, only one Israel-Gaza border crossing is open for cargo. In July, the Israeli Coordination and Liaison Administration increased the number of trucks that are allowed to unload at the crossing, but Hatem Oweida, the Health Ministry's director-general, said that has had little effect. "It's as if they never eased the siege," he said.
The unreliable electrical supply has left al-Shifa at the mercy of its backup generators for 12 or more hours a day. The generators take several seconds to kick in after the power dies, damaging sensitive machines such as the CT scan, MRI and kidney dialysis equipment, which are forced to shut down abruptly and then restart. Water pumps stop. So does the pharmacy's air conditioner, risking damage to medicine such as a small and precious cache of cancer treatments worth millions.
Al-Ashi said Gaza is entitled to 40 percent of all the medical supplies in the Palestinian Authority, but that since January, the Palestinian Authority in Ramallah has provided only 10 percent of that.
"When we say we need medicines in a week, Israel gives us permission for them to enter after one month. When we get the approval, Ramallah sends only part of our order or nothing at all," he said. "This means that both sides are participating in the siege. Everyone plays a role -- Israel by its blockade, and Ramallah by cutting off the supplies that we need."
Ghassan Khatib, a spokesman for the Palestinian Authority in Ramallah, said 50 percent to 60 percent of the Palestinian Authority's budget is devoted to providing services in Gaza, including health services. "I doubt their figures are correct," he said.
Faced with so few health options, many in Gaza are looking abroad. Egypt opened its Rafah border crossing after Israel's raid this year of a Turkish ship, and the WHO says the flow of patients to Egypt is thought to have doubled.
The WHO estimates that every month, 1,000 Gazans apply for permits to travel elsewhere for medical care. Some 80 percent are approved eventually, but Physicians for Human Rights has charged that in some cases, Israeli authorities have pressured patients to provide information or collaborate in exchange for permits.
"The rest either have their files reviewed, or they seek alternative care, or they die," said Mahmoud Zahar, the director of the Gaza office of the World Health Organization. The WHO has documented as many as 40 cases of people who died while they were awaiting permission to seek treatment in Israeli hospitals, he said.
Source
